Lege Artis Medicinae

[Position of the Scientific Council for Health on naturopathic practices and procedures and the medical use of unproven medicinal products not recognised as medicinal products]

FEBRUARY 26, 1992

Lege Artis Medicinae - 1992;2(02)

[At a time when our health care system is about to be renewed, the ETC plenary necessarily addressed the question of the type of system in which domestic medicine and patient care operate, and the place and role of naturopathy, which in previous decades was the only recognised and accepted form of scientific medicine, and which predominantly used only physical procedures and natural substances. This is a question of concern to health professionals and the general public alike, and one that is subject to many extreme views, ignorance and anger. The need to improve the health and health culture of the Hungarian population, the renewal of the health care system and, not least, the prestige of Hungarian medicine and medical science, make it necessary to raise the issue and to reconcile the views of the stakeholders. ]



Further articles in this publication

Lege Artis Medicinae

[New methods of plastic surgery for breast reconstruction]


[The treatment and plastic surgical reconstruction of breast tumour patients raise contradictions and unsolved problems. The approach of breast tumour surgery has been changed recently. New evidence shows that in terms of survival, free from distant disease there is no significant difference between lumpectomy and radical mastectomy. Thus breast-conserving operations as a replacement for radical mastectomy have been spreading. The most characteristic features of these operation are: the horizontal incision, the conservation of the pectoral muscles and the whole or partial preservation of glandular tissues. The quality and quantity of available tissues for the breast reconstruction have changed as, the methods of plastic surgical operations has been adopted. New methods for breast reconstruction such as muscle and musculocutaneous flaps, free flaps, different breast implants, and skin expanders have become more and more preferred. For nipple and areola reconstruction local flaps, skin grafts, external prostheses and tattoo are widely used. Nowadays the most important point of view in there the construction of the breast are accurate symmetry, aesthetic breast form and harmony of the whole body. ]

Lege Artis Medicinae

[Results in the sclerotherapy of varicocele]


[Testicular varicocele which is curable by surgical or transcatheteric methods is one of the most common causes of male infertility. In this study the success of the interventional radiological method was evaluated. Internal spermatic vein phlebographies were performed in the case of left sided varicocele. Before intervention the anamnesis, inspection, palpation, sonography, colour Doppler sonography and phlebography was evaluated and in a part of the cases spermiogramm too. Follow up examinations were performed at 3, 6 and 12 months after the sclerotherapy and the 1.5-4.5 years then later. The internal spermatic vein was succesfully occluded in 2/3 of the patients in the distal third, in 1/3 in the middle or in the upper third. Complications occurred in 10 cases as intima lesions without any consequencies and in 4 patients as scrotal thromboph lebitis. At the follow up examinations very good regression was demonstrated. Persistence or recurrence occured in 5.7% of cases. The spermiogramm usually got back to normal or showed an improvement and we registered 8 pregnancies from 23 formerly infertile marriages. The interventional radiological method is simpler, cheaper, requires shorter time and inpatient period, decreases sick-allowance, and the success rate reaches the level of the surgical method. The joint evaluation of the real time and the colour Doppler ultrasound is a very sensitive method in the interpretation of the results of the treatment. In our opinion sclerotherapy with Varicocid is the method of choice in the treatment of the varicocele. ]

Lege Artis Medicinae

[Mapping of EEG in neurological disorders]


[Mapping is a new way to convey the information of the mathematical analysis of the EEG in an immediately understandable form. In this article, the history of EEG mapping is surveyed. Sixteen channel EEG mapping system was programmed on an IBM-AT personal computer which constructs absolute and relative power spectra topograms on the scalp. Hemispheric asymmetry and long term changes of absolute and relative power estimates were calculated by statistical methods (Wilcoxon and Student t-test). In comparison traditional reading of the EEG the mapping has the following advantages: 1. it uses exact procedures instead of qualitative estimation; 2. in can detect minimal cortical damages; 3. it has the ability to store data for later comparison: the power ratios in selected frequency ranges proved to be a reliable indicator of post-ischemic restitution of EEG; 4. it can evaluate of event related reactions of bioelectric signals in higher resolution. EEG topography provides early information regarding the severity of ischemic lesions in the acute stage of stroke before to the CT scan can visualize the tissue hypodensity. In cases of permanent epileptic waves, the mapping visualizes the local power maxima of dominant frequency ranges and detects the post-ic talimpairment of cortical fields of epileptic foci. Probability significance mapping has reinstated the diagnostic value of EEG by the applica tion of the neuroimaging techniques.]

Lege Artis Medicinae

[Bidirectional Doppler investigation of the internal carotid artery]


[The blood-flow velocity in carodit arteries was measured with a bidirectional CW Kranz bühler 761 Doppler instrument. These investigations were supplemented with special compression tests. 60 investigations were performed to study the blood-flow in the supraorbital and supra trochlear arteries, while compressing the superficial temporal, the facial and the common carotid arteries. The results were compared with 30 regularly performed angiographies. Conclusions: the sensivity of this method is 80%, the specificity is 85%, its positive and negative predictive values are 76% and 87% respectively. Therefore this method is suggested for screening the internal carotid artery. ]

Lege Artis Medicinae

[Ultrasound examination of the knee]


[The knee is frequently injured. In addition to the phisical examination imaging methods are very important in determining the diagnosis of the disorders. Ultrasound method is useful in revealing the injuries of the soft tissues of the knee. The authors examined 350 patients with an Acuson 128 ultrasound machine, using 5 and 7 MHz linear transducer in standard positions. They analized the pathological disorders of the knee joint. They consider the examination of network of the band important. Sonography has a significant role in the diagnosis of knee disorders. That can replace more expensive or invasive examination methods.]

All articles in the issue

Related contents

Clinical Neuroscience

Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]